The nursing instructor is observing a student nurse who is performing abdominal palpation on an adult client. In order to assess organs that lie deep within the abdominal cavity (e.g., kidneys, spleen),

Question

the student nurse should press on the client's abdomen using which of the following techniques?
1. Downward pressure of 1–2 cm using the finger pads
2. Side to side pressure of ½–1 cm using the finger pads
3. Downward pressure of 2–4 cm using the palmar surface of the fingers
4. Light pressure using the base of the fingers (metacarpophalangeal joints)

Answer 1

3
Rationale 1: Downward depression of 1–2 cm using the finger pads is not sufficient depth to assess structures that lie deep within the abdominal cavity. This describes moderate palpation, used for most of the structures of the body, but not the kidney or spleen.
Rationale 2: Side-to-side palpation of ½–1 cm in depth will not be sufficient to examine structures that lie deep within a body cavity or those that are covered with thick muscle. This may be sufficient to determine the size and consistency of a finding in the soft tissue (such as a cervical lymph node).
Rationale 3: Deep palpation of 2–4 cm (3/4–1½ inches) is used to palpate an organ lying deep within a body cavity such as the spleen or the kidneys. This is done by placing the palmar surface of the fingers of the dominant hand on the skin surface with the extended fingers of the nondominant hand covering and guiding the fingers downward.
Rationale 4: Light pressure using the base of the fingers or metacarpophalangeal joints is the technique used in the assessment for vibratory tremors, or fremitus.